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General NPI Number Information
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NPI Number | 1285189324
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Entity Type | Organization
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Legal Business Name | CLEARPATH HEALING ARTS CENTER
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Dates
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Enumeration Date | 08/18/2016
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Last Update Date | 08/18/2016
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Provider Practice Location Address
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Address Line | 3835 N FALLS RD
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City | BURDETT
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State | NY
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Zip | 14818-9639
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Country | US
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Telephone | 607-703-0510
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Fax | 607-703-0510
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Provider Business Mailing Address
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Address Line | 3835 N FALLS RD
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City | BURDETT
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State | NY
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Zip | 14818-9639
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Country | US
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Telephone | 607-703-0510
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Fax | 607-703-0510
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Authorized Official
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Title or Position | OWNER
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Name | MR. ANDREW JOHN SEUBERT
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Credential | LMHC, NCC
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Telephone | 607-703-0510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R051452-1
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License Number State | NY
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